| NPI | 1376899708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDA DABOVIC Phn 718-476-7636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: NY 496215) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2012-08-03 |